Individual provider Active NPI

Kay S Deford, NP

  • Acute Care Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1750542759
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
71001452A Issued in IN
Practice address
1800 N Capitol Ave
NP E-140
Indianapolis, IN 46202-1218
Phone
(317) 962-2894
Fax
(317) 963-5285
NPI assigned
Jun 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 71001452A IN Primary

Addresses

Primary practice location

1800 N Capitol Ave
NP E-140
Indianapolis, IN 46202-1218

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other identifiers 1

IdentifierTypeStateIssuer
201097070MedicaidIN

Other names 1

  • Kay S Miller Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kdeford@direct.iuhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101105000999 IN Practitioner - Nurse Practitioner 3678768488 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71001452AINMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana Clinic Critical Care LLC CurrentSince Sep 7, 2010 Accepting new patients

Locations

2574 Reliable Pkwy
Chicago, IL 60686

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

1801 Senate Blvd
Ste 230
Indianapolis, IN 46202
Phone (317) 962-5280

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1750542759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N CAPITOL AVE",
            "address_2": "NP E-140",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021218",
            "telephone_number": "317-962-2894",
            "fax_number": "317-963-5285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFORD",
        "first_name": "KAY",
        "middle_name": "S",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2023-03-07",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71001452A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201097070",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdeford@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "1800 N Capitol Ave",
            "address_2": "NP E-140",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KAY",
            "last_name": "MILLER",
            "middle_name": "S",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.